When April rolls around, I snap into hay-fever defense mode: I pop daily Zyrtec, squirt Flonase up my nose twice a day and stuff tissues into every bag I own. Oh, and I carry my asthma inhaler. Yay, spring?!
My fellow allergy sufferers, it’s not our imaginations: “Allergies are getting worse every year,” confirms Elise Liu, MD, an instructor in the Department of Allergy and Immunology at the Yale School of Medicine in New Haven, Connecticut. She says it’s partly due to climate change making allergy season last longer, but there are other factors experts are still teasing out.
But beyond severity, it seems like women suffer more from allergies. Case in point: My husband will have a day or two when he complains of a tickle in his throat, and meanwhile, I’m hopped up on every allergy medicine known to womankind.
To find out if allergies actually affect women differently than men, I combed the scientific research and talked to Dr. Liu and Payel Gupta, MD, a New York–based allergist, immunologist and spokesperson for the American College of Allergy, Asthma and Immunology (ACAAI). Read on to learn the truth about women and allergies, and get tips for surviving the season of itchy throats, tearing eyes and exploding sinuses.
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Who’s more likely to have allergies: women or men?
Women have higher rates of allergies than men do, according to the National Center for Health Statistics.
But it doesn’t start out that way in childhood. More boys (21.3%) than girls (19.8%) have seasonal allergies, while asthma affects 7.3% of boys and 5.6% of girls. “The flip happens at puberty, and it’s not a coincidence because it tracks almost perfectly with the hormonal changes of adolescence,” explains Dr. Gupta.
By the time they reach adulthood, women have taken the lead, with 29.5% of women suffering from allergies, compared with 20.7% of men. Women also have asthma at higher rates than men (9.7% to 6.2%).
Exactly why are women more prone to allergies?
Hormones play a key role in this allergy gender gap. “It’s one of the most striking examples of how sex hormones fundamentally shape immunity,” Dr. Gupta says.
As kids, boys have higher rates of allergies and asthma because of differences in airway size and immune development. “But once estrogen rises in girls, the immune system shifts,” Dr. Gupta explains. Estrogen tends to amplify a specific immune response responsible for allergic inflammation, she adds. “So what was a boys’ disease in childhood becomes a women’s disease in adulthood.”
Here’s how this plays out: “Estrogen can activate the allergy cells in our body, which are mast cells,” Dr. Liu says. “Mast cells produce chemicals, including histamine, which is the major chemical driver that leads to what we think of as allergy symptoms.” And since women’s mast cells are more easily triggered due to estrogen, it likely takes less for them to react to allergens, according to Dr. Liu.
Do women have more severe allergies too?
There’s no way to sugarcoat this: Women suffer more severe allergic reactions and symptoms too.
“Women have higher rates of anaphylaxis, more severe asthma and are more likely to be hospitalized for allergic disease,” Dr. Gupta says. A 2024 study in BMJ Open Respiratory Research, for example, found that women have more asthma flares and worse airway constriction than men. Women are also more likely to experience drug hypersensitivity reactions and adverse medication effects, Dr. Gupta adds.
It’s partly biological, as estrogen-primed mast cells may react easily. But it’s also a symptom of a problem in health care: Women’s symptoms are still undertreated and/or attributed to anxiety, Dr. Gupta adds. “When a woman comes in with severe allergic disease, we need to take it seriously.”
Does menstruation affect allergy symptoms?
Absolutely. Women’s allergy and asthma symptoms can fluctuate with the hormonal ups and downs of the menstrual cycle. “Many women notice this even before they have the language for it,” Dr. Gupta says. “The luteal phase, the week or two before menstruation, is when progesterone drops and estrogen fluctuates, and this is when many women report their worst asthma days and most intense allergy symptoms.”
Beyond that common annoyance, there’s a very rare condition some women have called progesterone hypersensitivity. “Women can be allergic to the sex hormone progesterone,” Dr. Liu says. The typical pattern is hives, but sometimes extreme systemic allergic reactions, known as anaphylaxis, can occur when progesterone levels are high each month. (Progesterone, you may remember from health class, peaks days after ovulation, then bottoms out.) Women with this immune condition may also react to infertility treatments due to exposure to the hormone.
Symptoms of progesterone hypersensitivity sometimes go away at menopause or during pregnancy, according to a report in the Annals of Allergy, Asthma and Immunology. But if you have unexplained cyclical hives, be sure to see an allergist; you may need to carry a two-pack of emergency epinephrine devices, such as EpiPens.
What’s the best way to treat allergies in women?
The first step is to find an allergist who understands how the female sex can affect allergies. “There aren’t sex-specific allergy medications per se, but there absolutely should be more individualized thinking,” says Dr. Gupta.
This is especially true if a woman is expecting. “During pregnancy, medication safety becomes a major consideration,” Dr. Gupta says. Biologic allergy medications like dupilumab or omalizumab are increasingly important for women with severe disease, she adds. “Sex-stratified data in clinical trials has been lacking,” she says, “and we need to change that.”
Beyond that, here are some targeted strategies every woman with allergies should know:
Jump on allergy meds early
“Seasonal allergies are highly treatable, so don’t try to white-knuckle through it,” Dr. Gupta says. The trick to feeling better is to time your medications and begin early. “Antihistamines and nasal steroid sprays are most effective when you start using them before your season begins, not after your symptoms are already raging,” Dr. Gupta says.
Tree-pollen season starts as early as February in parts of the U.S. and lasts into summer, according to the ACAAI. Grass season peaks in late spring and summer; ragweed starts in late summer and goes through fall. Mold allergy is considered a year-round allergy, but it can kick up outdoors in fall.
Track symptoms during your cycle
If you notice your allergies or asthma are reliably worse at certain points in the month, Dr. Gupta suggests noting when symptoms flare and sharing that with your doctor.
Get tested
Ask an allergist for skin and blood allergy testing to pinpoint what substances trigger your symptoms. Knowing exactly what you’re allergic to helps you avoid them. For instance, if you’re allergic to dust mites, you can invest in allergy-proof pillow protectors and good air purifiers. Knowing your triggers also allows for targeted treatment through immunotherapy (aka allergy shots).
Consider allergy shots
If you’re miserable with allergies, you may want to consider shots for either seasonal allergies (like birch pollen) or year-round ones (like dust mites and cat or dog dander). “It’s the only treatment that actually changes the underlying disease rather than just masking symptoms,” Dr. Gupta says, “and it’s generally safe and highly effective in women, though we typically don’t start it during pregnancy.”
Have your own back
If you have allergies, you don’t have to suffer in sniffly silence. “Women with allergic disease are more likely to be undertreated,” Dr. Gupta says. “If your symptoms are affecting your sleep, your work, your quality of life, make sure you tell your doctor.”
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Sources:
- Payel Gupta, MD, spokesperson for the American College of Allergy, Asthma and Immunology; email interview, April 10, 2026
- Elise Liu, MD, PhD, instructor in the Department of Allergy and Immunology at Yale Medical School; phone interview, April 10, 2026
- National Center for Health Statistics: “Diagnosed Allergic Conditions in Adults: United States, 2024”
- National Center for Health Statistics: “Diagnosed Allergic Conditions in Children Ages 0−17: United States, 2024”
- BMJ Open Respiratory Research: “Sex differences in asthma control, lung function and exacerbations: the ATLANTIS study”
- PubMed Central: “Progestogen Hypersensitivity: presentation and natural history”
- Frontiers in Allergy: “Sex hormones and allergies: exploring the gender differences in immune responses”
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